BACKGROUND:Bone marrow stromal stem cels have a strong osteogenic potential, which are currently the most ideal seed cels for tissue engineering. However, there is no clinical report on the treatment of benign bone tumors and tumor-like lesions using bone marrow stromal stem cel transplantation.
OBJECTIVE: To investigate thein vivo perfusion method of inducing bone marrow stromal stem cels, and the clinical effects of bone marrow stromal stem cels on benign bone tumors and tumor-like lesions.
METHODS: Sixty-five cases of benign bone tumors and tumor-like lesions were divided into three groups according to the different treatments: bone graft group (n=30) and bone marrow stromal stem cels group (n=35). In the bone graft group, alogeneic bone was soaked in normal saline for 30 minutes, and then implanted into the bone defect site. In the bone marrow stromal stem cels group, 20-40 mL of bone marrow from each patient was extracted to isolate, purify and culture bone marrow stromal stem cels that were then perfused into the bone defect site.
RESULTS AND CONCLUSION:Under the inverted phase contrast microscope, the perfused cels appeared as a spherical shape, with different sizes. Initialy, there were more hematopoietic cels in the perfusion cel culture. With the extension of the culture time, adherent spindle cels and suspended red blood cels appeared, which were mostly round and triangular. Al the patients were folowed up for 1-12 months and healed wel after surgery. Compared with the bone graft group, infection rate and healing time were both lower in the bone marrow stromal cel group. To conclude, in vivo perfusion of bone marrow stromal stem cels used for construction of tissue-engineered bone promotes blood supply reconstruction and bone healing in patients with benign bone tumors and tumor-like lesions, which is of high clinical values.

It is important to put the professional quality training into the course of specialties in higher vocational education of the Rehabilitation Therapy, including the thinking mode of rehabilitation medicine, team working, communication, and personality of love, patience and responsibility and so on.

: This paper introduced the experience of choice of materials, contents and teachings as well as the teachers construction in Neurorehabilitation.

Objective To evaluate the reliability and validity of the Chinese version of the Newest Vital Sign(NVS). Methods The NVS was translated and back-translated. Cultural adaption of scale was performed by Delphi expert consultation and pilot study. The reliability and validity of the Chinese version of the NVS was tested in 451 Chinese residents. Results Chinese version of the NVS consisted of 6 items with Pearson correlation between item and total score of scale ranging from 0.50 to 0.71. Two factors were abstracted by exploratory factor analysis and explained 61.51% of total variance. Confirmatory factor analysis showed that the fitness of the model was acceptable:comparative fit index was 0.96, Tuker-Lewis index was 0.92, standardized root mean square residual was 0.04, root mean square error of approximation was 0.077. Cronbach α coefficient was 0.71, retest reliability was 0.92. Conclusions Chinese version of the NVS has good reliability and validity, which can be used to test the health literacy of residents in China.

BACKGROUND:CT-guided percutaneous intervention and rehabilitation techniques are both classic programs for diagnosis and treatment of lumbar disc herniation. Is the combination of CT-guided percutaneous intervention and rehabilitation techniques preferential y used for treatment of lumbar disc herniation?
OBJECTIVE:To evaluate the curative effect of CT-guided interventional injection combined with rehabilitation integration treatment for lumbar disc herniation and to analyze prognostic factors.
METHODS:Eighty-eight patients with lumbar disc herniation were subjected to CT-guided interventional injection combined with rehabilitation integration treatment from May 2010 to May 2013. Injection medicine consisted of betamethasone, tanshinone Ⅱ A sulfonate, neurotropin, normal saline and iohexol. Rehabilitation integration treatment included traction, manipulation, acupuncture, transcutaneous electrical nerve stimulation and thermal magnon. Macnab criteria and Chinese version of Oswestry low back pain disability questionnaire were used to assess the curative effects in comparison with the 112 patients receiving only CT-guided interventional injection that were reported previously. The prognostic factors, such as age, disease course time and herniation type of target segment were testified by correlation analysis.
RESULTS AND CONCLUSION:Total y 77 patients were completely fol owed up for 1 year. There were excellent outcomes in 64 cases, while favorable outcomes in 7 cases, fair outcomes in 5 case, poor outcome in 1 case, with a better outcome rate of 92%.There was a significantly decreased trend in Oswestry disability Index scores at 1, 6, 12 months during the fol ow-ups (P<0.01). No severe complications occurred in al the included patients. The curative effects were improved in term of better outcomes rate compared with the 112 patients receiving only CT-guided interventional injection, but there was no significant difference (P>0.05). The young group (≤ 45 years) had better outcomes than the older group (>45 years;P<0.01). In addition, disease course time and herniation type of target segment were not statistical y significant risk factors predicting clinical results (P>0.05). These findings indicate that CT-guided interventional injection combined with rehabilitation integration treatment could relieve lower back pain and radical leg pain effectively and decrease life disability level.

Objective: To explore the relationship between the changes of plasma levels of resistin with the contemporary body weigh changes in the same population. Methods: The community based epidemiological surveys were carried out in the same population in Shijingshan district of Beijing at the year of 2005 and year of 2010. A total of 943 subjects with the entire information of cardiovascular related risk factors were enrolled including 316 male with the mean age of (58.2 ± 8.5) years and 627 female with the mean age of (59.3 ± 7.5) years. Plasma levels of resistin in both year of 2005 and year of 2010 in all subjects were recorded, and the subjects were divided into 4 groups based on the quartile levels of resistin. Group①, the subjects with plasma level of resistin ≤ (-0.66) mmol/L,n=239, Group②, resistin level (from -0.67 to 0.25) mmol/L,n=233, Group③, resistin level (0.26-1.24) mmol/L, n=235 and Group④, resistin level ≥1.25 mmol/L,n=236. Pearson correlation study with uni- and multi- regression analysis were conducted to investigate the relationship between the changes of plasma levels of resistin with the contemporary body weight changes in the same population.Results: The uni-variate analysis showed that in female subjects, plasma levels of resistin were obviously related to the percentage (%) of body weight changes (correlation coefifcient: 0.1173), body weight index (kg/m2) changes (0.1521), the% of body weight index changes (0.1412), the waist circumference (cm) changes (0.1228) and the % of waist circumference changes (0.1057) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Multi-regression analysis indicated that with adjusted baseline variables, in female subjects, the plasma levels of resistin were obviously related to body weight (kg) changes and the % of body weight changes (regression coefifcient: 0.0261 and 0.2916), body weight index (kg/m2) changes and % of body weight index changes (0.2157 and 0.3072), the waist circumference (cm) changes and the% of waist circumference changes (0.0532 and 0.2738) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Conclusion: The changes of plasma levels of resistin are signiifcantly related to contemporary body weight changes in female subjects, but not in male subjects.

OBJECTIVETo evaluate whether intraoperative autologous donation (IAD) can reduce perioperative blood transfusion for patients underwent mitral valve replacement (MVR).

METHODSA total of 318 patients received implementation of IAD from January 2011 to December 2013 were analyzed retrospectively, and compared with 517 patients of the previous 36-month period (from January 2008 to December 2012). The method of small-volume retrograde autologous priming, strict blood transfusion standard along with IAD together constituted a progressive blood-saving strategy. Statistical methods including Students' t-test, Pearson's χ(2) test, Kruskal-Wallis analysis and multivariate Logistic regression model were used for comparisons of the data.

RESULTSThere were no significant difference between IAD group and non-IAD group considering preoperative patient demographics, characteristics and preoperative comorbidities. However, IAD group significantly reduced number of patients transfused with intra/post-operative packed red-blood cell (PRBC) (55(17.0%) vs. 215 (42.1%), χ(2)=53.0, P=0.000), and had significantly reduced postoperative chest tube output (150(380) ml vs. 700(660) ml, H=195.648, P=0.000), length of stay ((16±6) d vs. (20±8)d, t=9.60, P=0.000). But hematocrit were lower in IAD group (30%±5% vs.33%±4% at end of operation, t=7.76, P=0.000; 30%±4% vs. 32%±5% at discharge, P=0.000, t=3.86). Multivariate logistic aggression analysis revealed that age, IAD and smoking history were factors influencing the probability of intra or postoperative blood transfusion.

CONCLUSIONImplementation of blood conservation strategies based on intraoperative autologous donation in mitral valve replacement surgery can significantly reduce intra/postoperative blood transfusion as well as postoperative complications.

Blood Transfusion, Autologous ; Bloodless Medical and Surgical Procedures ; Cardiac Surgical Procedures ; methods ; Hematocrit ; Humans ; Logistic Models ; Mitral Valve ; surgery ; Postoperative Complications ; Retrospective Studies

Objective To investigate the common initial clinical presentations of primary Sj(o)gren's syndrome (pSS) with pulmonary complications,and to explore the differences between patients with extraglandular manifestations at disease onset (EGM) and those with glandular manifestations at disease onset (GM).Methods A total of 1 341 hospitalized SS patients from 2003 to 2012 were retrospectively reviewed.Of them,102 hospitalized patients with pSS'associated lung disease were analyzed and included.Case control study was performed to explore the differences between the EGM group and the GM group.Results Fifty-one percent of patients were presented with EGM at onset,with significantly shorter disease duration [36 (12,156) m vs 102 (48,159) m,x2=-2.41,P=0.016].Although the mean diagnose time was similiar,only 4％ of the EGM group could be confirmed the pSS diagnose at onset,which was significantly less frequently than that of the GM group (34％,22=15.29,P＜0.01).Case control study revealed that hyperglobulinemia,elevated RF titers and anti-SSA and/or anti-SSB test positive were less predominant in the EGM group [IgG 16(12,21) g/L vs 21 (15,28) g/L,x2=-2.15,P=0.032;22 (20,171) U/ml vs 104 (20,238) U/ml,x2=-l.98,P=0.048;33％ vs 72％,x2=15.78,P＜0.01].The predicted value of TLC and FVC were lower [(87±23)％ vs (97±20)％,x2=-1.96,P=0.050;(8±28)％ vs (100±27)％,x2=-1.70,P=0.089] and HRCT score was higher in EMG group [12(88,15) vs 8(5,13),x2=-1.82,P=0.070].Conclusion EMG at onset is the common initial manifestation of pSS'associated lung involvement.Pulmonary complication is more progressively and severe than those with MG at onset.Anti'SSA positive,elevated RF titer and hyperglobulinemia are not predominant for patients with EMG at onset.

Objective To investigate the value of bedside lung ultrasound B-line score in the diagnosis of acute heart failure (AHF). Methods A retrospectively analysis was conducted. The adult patients presenting with acute dyspnea in intensive care unit (ICU) of Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2016 to June 2017 were enrolled. An 8-zone lung ultrasound was performed and plasma B-type natriuretic peptide (BNP) level was tested in all patients. AHF was determined as the final diagnosis by two experienced ICU doctors according to the diagnostic criteria of AHF. Patients were divided into two groups: AHF group and non-AHF group. The levels of BNP and B-line score were compared between the two groups, and the diagnostic value of BNP and B-line score in AHF was evaluated. Results Fifty-six patients were included in this study, with 32 of men and 24 of women,and with an average age of 77.3±8.8. Thirty-six patients were diagnosed as AHF. The level of BNP and lung ultrasound B-line score in AHF group were higher than those in non-AHF group [BNP (ng/L): 1 640.4±1 078.4 vs. 236.9±124.9,B line score: 12.8±5.3 vs. 5.4±1.8, both 1 < 0.01]. There was a strong correlation between elevated BNP levels and an increased B-lines score (R2 = 0.712, 1 = 0.000). The receiver operating characteristic curve (ROC) showed that when the cut-off of lung ultrasound B-line score was 8.5, AHF could be discriminated from dyspnea caused by other diseases (sensitivity was 77.8%, specificity was 95%, positive likelihood ratio was 15.56, negative likelihood ratio was 0.23).The area under the ROC curve (AUC) of lung ultrasound B-line score was 0.917 [95% confidence interval (95%CI) =0.847-0.987, 1 = 0.000], slightly lower than that of plasma BNP [0.979 (95%CI = 0.951-1.008)]. Conclusion Lung ultrasound B-line score was highly specific, but moderately sensitive for identifying patients with AHF.

Objective To analyze the changes in the anterior talofibular ligament(ATFL)after injury in patients with ankle sprains.Methods A total of 97 ATFL injury patients with ankle sprains exceeding 3 months and clinical symptoms were selected as injury group from the outpatient department of Huzhou Central Hospital from January 2019 to December 2021.During the same period,A total of 112 healthy individuals were recruited as control group.The echo changes of ATFL on both sides of the enrolled patients were explored under the natural and stress states of the ankle joint,the length,width,and thickness of ATFL were measured.The ATFL data changes of the two groups of enrolled patients were statistically analyzed.Results The ATFL boundaries of patients in injury group were mostly unclear,and the ligament echoes were disordered;The ATFL boundaries of control group participants were clear,with uniform echoes.There were no statistically significant differences in the length,width,and thickness of ATFL on both sides(P>0.05).The comparison of ATFL on both sides of injury group patients showed an increase in the length and thickness of ATFL on the injured side,with statistical significance(P<0.05),while the difference in width was no statistically significant(P>0.05).The length and width of ATFL increased in injury group of patients with natural injury than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was not statistically significant(P>0.05);The length and width of ATFL in injury group of patients increased under stress than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was no statistically significant(P>0.05).The comparison of the difference in length,width,and thickness of ATFL between the two groups of participants under non stress and stress states showed that the differences in length and thickness of ATFL in injury group were statistically significant(P<0.01),while the difference in width change was no statistically significant(P>0.05).Conclusion The length of ATFL in patients with ankle sprains significantly increases under stress and natural conditions,and the difference in ATFL length changes was also more pronounced.